Prostaglandins of the A, E, and I type inhibit gastric acid secretion. The prostaglandins also stimulate increased mucus and bicarbonate secretion by gastric mucosa. Misoprostol (Cytotec), which is an analogue of prostaglandin E1, has been approved for use in the prevention of nonsteroidal antiinflammatory drug-induced ulceration. It also is approved in other countries for the treatment of peptic ulcer disease. Misoprostol is absorbed rapidly after oral administration and is hy-drolyzed to the active compound. It is metabolized by the liver and excreted mainly in the urine. Adverse effects include crampy abdominal pain, dose-related diarrhea, and uterine contractions. The last-named effect has led to its use in the control of postpartum bleeding (see Chapter 62).
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